Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Manfredo Florescruz

Individual provider Psychologist · NPI 1407673908

Manfredo Florescruz is a Clinical Psychologist in Fulton, Missouri. Qualified in 2024, 2 years ago. Practices with State of Missouri, a 51-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
2
Licensed in
MO
In the registry since
2024

Practice location Address checks out

600 E Fifith St
Fulton, MO 65251
Phone: (573) 592-2030
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychologist (primary) Taxonomy 103T00000X · Licence 2023049778 (MO)

Record details

NPI number1407673908
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 25, 2024
Last updated in NPPESSeptember 25, 2024
Certification dateSeptember 20, 2024
Mailing address600 East Fifith Street, Fulton, MO 65251

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL PSYCHOLOGIST
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice State Of Missouri — 51 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Fulton